Maban & Yida - UNHCR

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REFUGEE SURVEILLANCE UPDATE (MABAN AND YIDA) Epidemiological Weeks 5

21th- 27th January 2013

In this issue:

Highlights ..........................................................................................................................................1 Reporting Performance ......................................................................................................................2 Epidemic Prone Disease Reported ......................................................................................................3

Highlights 

  

 

The proportion of health facilities in Maban submitting weekly reports to the state and central level increased this week to 61% (14 out of 23) as compared to week 4 (see list of health facilities in Maban and supporting partners in page 2). Six health facilities serving refugees in Maban reported this week out of Seven facilities, while reporting from facilities serving the host communities improved this week 9 out of 15 facilities reported (few facilities are not functioning); Out of the three health facilities serving Yida refugee camp only one facility (MSF-F clinic) reported this week, Yida PHCC, and Wang Kuat PHCC run by CARE did not report. Acute watery diarrhea was the leading priority diseases recorded in the refugee camps, followed by acute jaundice syndrome and Malaria. Eight Hundred and ten (810) suspected Acute Jaundice Syndrome (AJS) cases or confirmed Hepatitis E cases and eight (8) related deaths were recorded from Maban and Yida. Of these, 98% of cases and 100% of deaths were reported in Maban refugee camp, Yusuf Batil in particular. Only 2% of cases were reported in Yida refugee camp. The cumulative AJS cases recorded from Maban refugee camps was 5,892 and 107 related deaths, while 125 AJS cases and 4 deaths were recorded in Yida as of week 5. The trend of AJS cases in Batil has been increasing since week 48 of 2012 till week 5 of 2013. There was no suspected Cholera, Meningitis, Measles or VHF cases reported from refugee camps, but the trend of acute watery diarrhea slightly increased this reported period. Assessments conducted by MSF in Yusuf Batil and camps on water and sanitation condition in the camps indicated that there are major gaps on sanitation and hygiene situation at household and Sheikdom levels. There are very few hand-washing at household or sanitation facility levels, while decommissioning full latrines is a major problem in all camps. Waste management at camp and market place is also a major gap which requires urgent attention. UNHCR and other partners are fully committed to scale up the water and sanitation interventions that will address the gaps identified through these assessments.

Silent Facilities: Genkwatta PHCC, Khortumbak PHCC, Banishowa PHCC, New Guffa, Baugaya PHCC, Doro PHCC (SIM) IMC Gendrassa Clinic, Yida PHCC and WangKuat

Refugee Surveillance Update by IDSR department, MOH-RSS

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Reporting Performance The total number of health facilities expected to report for Early Warning and Alert Response Surveillance (EWARS) system from Maban County is 23 facilities in Maban and 3 facilities in Yida, of these, seven facilities are serving refugees camps in Maban and 3 facilities are serving Yida refugee camp. Nonetheless, few health facilities serving host communities in Maban county are not functioning or there functionality various week by week. Table 1: Reporting Status of Health Facilities Serving Refugees and Host Communities in Maban and Yida

FACILITY IN MABAN

WK1

WK2

WK3

WK4

WK5

Doro camp clinic MSF-B Jamam CAMP MSF-H CLINIC Batil GOAL clinic(west & South) Batil MSF-H Batil Medair SE Clinic Gendrassa MSF H Gendrassa IMC Bunj PHCC Relief International Bunj Hospital SP/GOAL Dangaji PHCU Relief International Gesm Allah PHCU Relief International Jammam PHCU GOAL Banashowa PHCU SCiSS-MRDO Genkwata PHCU MOH Thuaye PHCU MOH New Guffa PHCU MOH Khor Tumbak PHCU MOH Puomkl PHCU SCiSS-MRDO Doro PHCU SIM Liang PHCU SCiSS-MRDO Nila PHCU SCiSS-MRDO Sheta PHCU SCiSS-MRDO Baugaya PHCU GOAL

1 1 1 1

1 1 1 1 1 1

1 1 1 1 1 1

1 1 1 1 1 1

1 1 1 1 1 1

1

1 1

Wang Kuat PHCC Yida PHCC MSF-France Clinic

Total Facilities Reporting

Refugee Surveillance Update by IDSR department, MOH-RSS

1

1

1

1

1

1 1 1 1

1 1 1 1

1 1 1

1

1 1 1

Total Facilities Reporting

FACILITIES IN YIDA

1 1 1 1

1 1 1

14

WK1

8

WK2 1 1 1 3

11

WK3 1 1 1 3

11

WK4 1 1 1 3

1 1 1 3

14

Wk5 1 1

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Epidemic Prone Disease Reported Acute Watery Diarrhea (AWD) A total of 1,790 AWD cases were reported from the refugee camps during this reporting week with no related deaths. Of these cases, 85% (1516) cases were recorded from Maban camp and 274 from Yida camps. Children below five years of age accounted for 58% of all reported AWD cases. Figure 1 below shows a comparison of AWD cases reported by Epi-week and year (2012 and 2013). The overall incidence rate of AWD across the camps in Maban County decreased slightly in week 5. The trend of AWD that has been increasing from week one of 2013, reached the second highest peak since week 30 of 2012. Sanitation and hygiene is still a major problem in the refugee camps and the risk of water borne disease outbreak is very high. Figure 1: Comparison of AWD Cases Reported from Refugee Camps in Maban by Ep-week(week 30/2012 - week 5/2013), Upper Nile 1800 1600 1400 1200 1000 800 600 400 200 0

Dysentery (ABD) A total of 222 cases of ABD

Figure 2: Comparison of ABD Cases Reported from Refugee Camps in Maban by Ep-week (week 30/2012 week 5/2013), Upper Nile

with no related death were reported from the Maban and Yida Refugee camps. Of reported

90%

from

250

were 200

Maban

refugee camps and 10% from Yida. Children below five

150 100

years of age accounted for

50

26.6% of all reported ABD

0

cases. Figure 2 below shows Refugee Surveillance Update by IDSR department, MOH-RSS

Week 30 Week 31 Week 32 Week 33 Week 34 Week 35 Week 36 Week 37 Week 38 Week 39 Week 40 Week 41 Week 42 Week 43 Week 44 Week 45 Week 46 Week 47 Week 48 Week 49 Week 50 Week 51 Week 52 Week 01 Week 02 Week 03 Week 04 Week 05

cases,

Axis Title

these

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a comparison of ABD cases reported by Epi-week and year (2012 - 20130. The ABD trend reported from the refugee camps in Maban has slight increased in the past three weeks, as compared to the previous weeks. It has reached to highest rate in week 5 since week 30 of 2012. Malaria A total of 588 malaria cases with no related deaths were reported in weeks 5 from Maban (348) and Yida (240). Of these cases, 29% of the cases were in children below five years of age. Figure 3 below shows comparisons of malaria trends by Epi-week. The malaria cases recorded in the refugee camps in Maban remains low in the past five weeks of 2013 as compared to the last few weeks of 2012 (refer to below figure 3,) while in 2013 trend has remained low. Figure 3 Comparison of Malaria Cases Reported from Refugee Camps in Maban by Ep-week (week 30/2012 - 5/2013), Upper Nile 2500

MALARIA CASES

2000 1500 1000 500

Week 30 Week 31 Week 32 Week 33 Week 34 Week 35 Week 36 Week 37 Week 38 Week 39 Week 40 Week 41 Week 42 Week 43 Week 44 Week 45 Week 46 Week 47 Week 48 Week 49 Week 50 Week 51 Week 52 Week 01 Week 02 Week 03 Week 04 Week 05

0

EPI WEEKS

Acute Jaundice Syndrome (AJS)

A total eight Hundred and ten suspected AJS cases and Eight (8) related death were reported on week 5 from all refugee camps in Maban and Yida. Over 78% of all cases were recorded in Yusuf Batil camp, followed

by

Jamam

(11%),

Gendrassa (7%), Yida (2) and Doro (2%). All the 8 deaths were in Batil

Table 2:Acute Jaundice Syndrome Case Fatality Proportion by Refugee Camp Camp Population AJS AJS Case Fatality (approx.) Cases Deaths Proportion* Jamam 15633 1320 25 1.9

camp. Refer to table 2 for

Gendrassa

14904

577

3

0.5

distribution of cumulative cases by

Yusuf Batil

37229

3937

77

2.0

camp. Figure 4, 5 and 6 shows Epi-

Doro

44704

58

2

3.4

Curve

Yida

60589

125

4

3.2

Total

173059

6017

111

1.8

in

Maban

AJS).

The

cumulative AJS cases recorded in

Maban as of week 5 was 5892 (suspected and confirmed HEV) and 107 deaths (CFR 1.8 %) as of week 5. As shown figure 4, the overall trend of AJS (confirmed or unconfirmed HEV) has significantly Refugee Surveillance Update by IDSR department, MOH-RSS

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increased from week 47 of 2012 till week 5 of 2012. Nonetheless, considerably upsurge has been recorded in Yusuf Batil, while trend of AJS cases have slightly increased in all other camps. 900

Figure 4:Epi-Curve of Acute Jaundice Syndrome cases in th Refugee camps and host communities in Maban and Pariang County (as of week 5) n=6017

700

Figure 5: Epi curve: Yusuf Batil Camp Acute Jaundice Syndrome Cases (as of week 5)

800

600 700

500 # of Cases

600 # of Cases

400

500 400

300

300

200

200

100

100

0

0 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 1 2 3 4 5

25

20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 Epi Week

Epi Week

Figure 6:Epi-curve of AJS/HEV cases in Yida camp (September 2012 - January 2013

# of Cases

20

15

10

5

0 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 Epi Week

Poor sanitation and hygiene practice compounded with inadequate distribution of clean water, lack of soap as hand-washing points and limited access to functioning latrines and too few hand-washing points are likely factors contributing the ongoing upsurge of hepatitis E cases and deaths in Maban refugee camps. There are opportunities to improve the current water and sanitation conditions in the refugee camps in order to contain the upsurge of the outbreak, and UNHCR together with WASH and Health partner are taking steps to implement the newly developed WASH action plans. Other Priority Disease: No suspected case of meningitis, Measles, ILI and VHF was reported during this

reporting period from all refugee camps.

However, Yida and Batil reported high numbers of

respiratory tract infections in the past three weeks.

Refugee Surveillance Update by IDSR department, MOH-RSS

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2

4

Table 3: Summary of Priority Diseases in Maban and Yida Refugee camps in Week 5 Camps

Doro

Batil

Gendrassa

Jamam

TOTAL (Maban)

TOTAL YIDA)

Yida

Cases/ Death

C

D

C

D

C

D

C

D

C

D

C

D

C

D

Suspected Cholera

0

0

0

0

0

0

0

0

0

0

0

0

0

0

AWD

611

0

373

0

6

0

526

0

1516

0

274

0

274

0

BD

34

0

43

0

0

0

124

0

201

0

21

0

21

0

Meningitis

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Measles

0

0

0

0

0

0

0

0

o

0

0

0

0

0

AFP

0

0

0

0

0

0

0

0

0

0

0

0

0

0

AJS

13

0

632

8

57

0

90

0

792

8

18

0

18

0

VHF

0

0

0

0

0

0

0

0

0

0

0

0

0

0

143

0

104

0

5

0

96

0

348

0

240

0

240

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

801

0

1152

8

68

0

836

0

2857

8

553

0

553

0

Malaria Neonatal Tetanus Total

8,260,490 national population; Incidence rate =Reported cases/Population at risk*100,000; Case fatality rate= Total death/total cases recorded*100 Key : AWD – Acute Watery Diarrhoea, , ABD – Blood Diarrhoea/Dysentery, Men – Meningitis, AJS – Acute Jaundice Syndrome, , AFP – Acute Flaccid Paralysis/Polio , NT - Neonatal Tetanus, 0 -Zero Report, C – Cases , D - Deaths , Timely reports - Reports received before Wednesday 10:00am, Completeness - Proportion of health facilities reporting in a county/state, Timeliness - Proportion of county in a state reporting on time. HFs- Health Facilities, EPI-Expanded program for immunization

For comments or questions, please contact: Surveillance Department, MoH-RSS, Tel: 0955551147; 0922186571; E-mail: [email protected], HF radio frequency: 8015 USP; CELL CALL: 7002

The Weekly Refugee Surveillance Bulletin is produced with the support of WHO and ECHO

Refugee Surveillance Update by IDSR department, MOH-RSS

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